Individual
DR. ERIC PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS MSD
Contact information
Practice address
710 N BEAVER ST BLDG 4, FLAGSTAFF, AZ 86001-3139
(928) 774-2745
Mailing address
710 N BEAVER ST BLDG 4, FLAGSTAFF, AZ 86001-3139
(928) 774-2745
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D6362
AZ
Other
Enumeration date
05/27/2008
Last updated
05/27/2008
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